Rebamipide enema therapy as a treatment for patients with active distal ulcerative colitis

Authors: Furuta, Ryuichi¹; Ando, Takafumi; Watanabe, Osamu¹; Maeda, Osamu¹; Ishiguro, Kazuhiro¹; Ina, Kenji²; Kusugami, Kazuo³; Goto, Hidemi¹

Source: Journal of Gastroenterology and Hepatology, Volume 22, Number 2, February 2007 , pp. 261-267(7)

Publisher: Wiley-Blackwell

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Abstract:

Background:

The clinical efficacy of corticosteroids in the treatment of ulcerative colitis (UC) is well-established. However, prolonged usage of these drugs can result in serious complications. Rebamipide {2-(4-chlorobenzoylamino)-3[2-(1H)-quinolinon-4-yl] propionic acid}, a cytoprotective agent, has been reported to have anti-inflammatory activity and to repair mucosal injury in animal colitis models. The aim of the present study was to assess the clinical efficacy and safety of a novel Rebamipide enema therapy in UC patients. Methods:

Twenty patients with the active distal type of UC in whom corticosteroid treatment had been unsuccessful were treated with rectal administration of Rebamipide twice a day for 3 weeks, during which corticosteroid dosage was kept constant. The efficacy of treatment was assessed from clinical symptoms and endoscopic findings. The anti-inflammatory effect of Rebamipide was also examined by monitoring changes in the intensity of histological inflammation and levels of cytokine activity in the rectal mucosa. Results:

At 3 weeks after the initiation of Rebamipide enema therapy, 11 patients (55%) achieved clinical remission. Sixteen (80%) were colonoscopically judged to be responders, with decreased levels of interleukin (IL)-1β but not of IL-8, and an increased ratio of IL-1 receptor antagonist/IL-1β in organ cultures of mucosal tissues. The change in the number of infiltrating neutrophils was not significantly correlated with the clinical response to this therapy. No side-effects were noted in any patients. Conclusion:

Rebamipide enema therapy proved to be safe and useful in corticosteroid-refractory patients with the active distal type of UC.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1440-1746.2006.04399.x

Affiliations: 1: Department of Gastroenterology, Nagoya University Graduate School of Medicine, 2: Division of Medical Oncology, Nagoya Memorial Hospital and 3: Department of Food Science and Nutrition, Nagoya Women's University, Nagoya, Japan

Publication date: 2007-02-01

Rebamipide enema therapy as a treatment for patients with active distal ulcerative colitis

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